Compulsive Health-Related Internet Use and Cyberchondria

Translation and validation of the Portuguese version of the internet severity and activities addiction questionnaire (ISAAQ-10) towards the identification of problematic social media use: A population study

BACKGROUND

Problematic usage of the internet (PUI) refers to a pattern of internet use that results in negative consequences in an individual's life. It encompasses a broad spectrum of activities, which require assessment in terms of both severity and diversity, for a comprehensive understanding. This study aimed to translate the Internet Severity and Activities Questionnaire (ISAAQ-10) into Portuguese, to analyze its psychometric properties and to explore the validity of the ISAAQ-10 social networking use activity score towards identifying problematic social media use.

METHODS

A snowball sampling method was used, with participants completing an online survey comprising sociodemographic questions and the Portuguese versions of the ISAAQ-10, Internet Addiction Test-10 (IAT-10), Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), and Bergen Social Media Addiction Scale (BSMAS). The psychometric analysis included internal reliability testing using Cronbach's alphas and test-retest reliability, a confirmatory factor analysis (CFA), and convergent validity testing between the ISAAQ-10 and IAT-10. The concurrent validity of the ISAAQ-10 was also examined.

RESULTS

A total of 590 young adults (85.1 % female), aged between 18 and 35 years, participated in this study. The ISAAQ-10 presented good internal consistency (α = 0.93), with a test-retest correlation of r = 0.865; 95 % CI: 0.669-0.939. and a unidimensional structure that explained 48.3 % of the total variance. The convergent validity of the ISAAQ-10's total score was established through a high Pearson's correlation (r = 0.574; p ≤ .001) with the IAT-10's total score. Pearson's correlations between the ISAAQ-10 gaming activity score and the IGDS9-SF (r = 0.873; p < .001), and between the ISAAQ-10 social networking use activity score and the BSMAS (r = 0.670; p < .001), respectively, supported the instrument's concurrent validity.

CONCLUSION

This work provides support for the Portuguese translation of the ISAAQ-10, which can be employed to identify the severity of problematic usage of the internet in a population sample. It also provides the first validation of the ISAAQ-10 social networking use activity score, which can be employed to identify problematic social media use within a predominately female university student sample. This study further establishes the ISAAQ-10 as a valid and reliable tool for population studies and, specifically, for the identification of problematic social media use.

Investigation of the effect of internet addiction on cyberchondria

This research was conducted to examine the effect of internet addiction on cyberchondria. The research is important to understand how today's digital technologies contribute to health-related concerns and affect individuals' perceptions of health. Quantitative research design was used in this research conducted in Konya, a metropolitan city in Turkey. The study was conducted using the convenience sampling method on 403 participants. In the research, 'Personal Information Form', 'Internet Addiction Scale' and 'Cyberchondria Scale' were used. The data were analyzed with the SPSS program. As an analysis method, upon determining that the data were normally distributed, t-test, ANOVA, Pearson correlation and simple linear regression analyzes were applied in independent groups. The majority of participants (69%) were female, 52.9% were between the ages of 18-27 and 53.8% were married. In terms of education level, 44.9% had a bachelor's degree or higher, and 59.6% earned minimum wage or less. Among the occupational groups, the largest proportion was students (31.5%), and their daily internet use was mostly 2-3 hours (44.4%). Internet is most frequently used for social media (47.4%) and news/agenda follow-up (25.1%). Within the scope of the research, internet addiction varies significantly according to the participants' age groups, education levels, professions, average daily internet usage time, and internet usage purposes; it was found that the cyberchondria levels of the participants showed significant differences according to the variables of income level, profession, daily internet usage time and internet use purpose. The research revealed a positive and significant relationship between the level of internet addiction and the level of cyberchondria. It has also been observed that internet addiction has a positive and significant effect on cyberchondria. These results show that cyberchondria tendencies become stronger with the increase in internet use among individuals.

Internet Use and Depressive Symptoms among Older Adults in the U.S.: Unraveling the Differences by Gender

The daily Internet use among older adults has increased. This study examines how Internet usage affects depressive symptoms among older adults, focusing on gender differences. Using data from the 2015 National Health and Aging Trends Study (N = 6380), weighted multinomial logistic regression analysis was conducted. Men tended to access the Internet more for instrumental purposes and health-related matters compared to women. Conversely, women used social networking sites (SNSs) more frequently. Men were more inclined to use the Internet for personal tasks and health concerns than women. SNS use was positively associated with mild and major depression in men, while email or texting was negatively linked to their major depression. Internet use for health matters was negatively associated with major depression in women. The discussion emphasizes potential service and policy innovations aimed at leveraging digital technology to improve the mental health of older individuals, considering gender differences.

The Relationship between Cyberchondria and Health Anxiety and the Moderating Role of Health Literacy among the Pakistani Public

Following the COVID-19 pandemic, the current study examines the association between cyberchondria and health anxiety in the Pakistani population, with health literacy as a moderator. This study utilized a cross-sectional research approach, with data gathered through simple random sampling. The study enlisted 1295 participants from Pakistan aged between 18 and 70, 63% of whom were male and 36% of whom were female. The researchers found a statistically significant positive link between cyberchondria and health anxiety (β = 0.215; t = 1.052; p 0.000). The moderating influence of health literacy suggests that health anxiety has a significantly negative effect on the relationship between cyberchondria and health anxiety (β = -0.769; t = 2.097; p 0.037). Moreover, females had higher cyberchondria scores than males. Health-related anxiety did not differ between the sexes, and males had greater health literacy than females. These results emphasize the critical role of health literacy in the moderating effects of cyberchondria on health anxiety. Furthermore, they reveal significant gender differences in both cyberchondria and health literacy.

Cyberchondria and smartphone addiction: A correlation survey among undergraduate medical students in Egypt

BACKGROUND

There is an increase in smartphone usage globally. Cyberchondria (CYB) is characterized by excessive Internet searches for health information. Smartphone addiction is constantly rising among medical students together with CYB as a collateral emerging risk, yet there is limited research available on the topic.

METHODS

This cross-sectional study explores the rising phenomenon of smartphone addiction and its potential role in CYB among medical students in seven Egyptian universities. A total of 1435 medical students participated in completing online questionnaires that assessed smartphone addiction and CYB using the Smartphone Addiction Scale-Short Version (SAS-SV) and Cyberchondria Severity Scale (CSS-12). Multivariable regression analysis was applied to assess predictors of smartphone addiction and CYB.

RESULTS

Based on the used scales, 57.6% of students were suffering from smartphone addiction, and 85.8% exhibited a moderate degree of CYB. There was a significant positive correlation between smartphone addiction scores and CYB (p < 0.05). The multivariable regression models revealed that four factors including using Facebook, using WhatsApp, increasing time spent on the Internet per day, and a higher CYB score increase the probability of smartphone addiction. The factors that increase the probability of CYB are using Facebook, an increase in the frequency of Internet searches, a higher degree of worry about one's health or a family member's health, and being a smartphone addict.

CONCLUSION

Smartphone addiction among undergraduate medical students is prevalent. Social media use, time spent online, and smartphone addiction were linked with the risk of CYB. Regular physical activity decreases the probability of smartphone addiction. Awareness programs and increased mental and physical activities are required to help reduce smartphone addiction among youth.

The digital health dilemma: Exploring cyberchondria, well-being, and smartphone addiction in medical and non-medical undergraduates

BACKGROUND

The Internet is a popular source of health information, but too much research can cause anxiety (cyberchondria). Medical and non-medical personnel interpret information differently, leading to varying rates of cyberchondria. Smartphone addiction may also contribute to cyberchondria and impact mental health.

METHODS

The study was an epidemiological survey-based investigation with a cross-sectional design involving undergraduate students (aged 18 years or older) from Indian universities or colleges. The study utilized the Cyberchondria Severity Scale-Short Form (CSS-12), WHO-5 well-being index, and Smartphone Addiction Scale-Short Version (SAS-SV).

RESULTS

A total of 1033 participants (53.1% females and 46.4% males) were recruited in the survey. Of the participants, 58.5% were pursuing medical or paramedical courses, while the remaining 41.5% belonged to the non-medical group. High-severity cyberchondria was present in about 4.4% of the students. The medical cohort demonstrated a significantly lower cumulative CSS in comparison to the non-medical cohort (t = - 3.90; P < 0.01). Smartphone addiction was observed in 57.2% of individuals in the medical group and 55.9% of individuals in the non-medical group (P = 0.68). Medical students had a significantly lower mean well-being score compared to non-medical students (58.4 vs. 59.6; P < 0.01). There was a positive correlation between cyberchondria severity and smartphone addiction, which was consistent across both groups.

CONCLUSION

Medical students have less cyberchondria than non-medical students. Cyberchondria severity is linked to smartphone addiction. Non-medical students with cyberchondria have higher subjective well-being.

Factors Associated with Korean American Women's Health-Related Internet Use: Findings from Andersen's Behavioral Model

Literature suggests that access to health information improves health outcomes in various medical domains. This study investigated health-related Internet use levels and examined which factors influence health-related Internet use in Korean American women, grounded by Andersen's Behavioral Model. Participants included 243 Korean American women aged 19-85 years old residing in a Southeastern metropolitan area. Health-related Internet use was assessed by 11 items taken from HINTS 4 Cycle 2. Multiple regression analysis was conducted to reveal factors significantly associated with health-related Internet use of Korean American women. Predisposing factors of being aged 60 or older (β = - 0.329, SE = 0.694, p = 0.004) and employment status (β = 0.179, SE = 0.404, p = 0.037), as well as an enabling factor of having a primary care physician (β = 0.217, SE = 0.423, p = 0.013), were significantly associated with health-related Internet use. The differences in health-related Internet use may exacerbate disparities in access to healthcare services. The primary care physician's role is important in enhancing health-related Internet use. Research, policy, and programmatic attention are necessary to enhance physicians' encouragement and education for patients to use existing digital technology to improve their health and wellness.

Examining online information-seeking behaviours and antenatal anxiety of expectant fathers

This study was designed to examine online information-seeking behaviours of expectant fathers regarding pregnancy and birth and their antenatal anxiety. The present study was conducted using 120 expectant fathers who accompanied their wives to the maternity outpatient clinic in western Turkey, İzmir Province. The fathers' anxiety levels were assessed using a trait anxiety subscale of the State-Trait Anxiety Inventory (STAI), which is a validated test for scoring trait anxiety (basal anxiety, STAI-T). The results showed that 92.5% of the expectant fathers searched for information online during pregnancy. They most frequently searched for the following topics: foetal development, complications to pregnancy and nutrition. The mean total trait anxiety scale score of the expectant fathers was 47.35 ± 6.98 (range = 31-62). The anxiety scores of the expectant fathers who searched for information on topics related to vaccination during pregnancy, exercise, antenatal tests, labour pain and childbirth signs were high. Health professionals should consider the information needs and concerns of expectant fathers during pregnancy while providing family-centred care.

Are Cyberchondria and Intolerance of Uncertainty Related to Smartphone Addiction?

Smartphones are a medium for performing online activities, and one such activity could be the compulsive online health information search - cyberchondria. This study aimed to test whether cyberchondria and intolerance of uncertainty (IU) positively predict smartphone addiction (SA), adjusted for age, gender, daily use duration, the reason for using smartphones, and symptoms of anxiety and depression. The sample consisted of 471 adults (55.2% women) from the general population without chronic diseases (Mage = 38.67). Regression analysis showed that IU was a positive predictor of SA (β = .17, p < .001), as well as cyberchondria (β = .14, p < .001), which had a unique contribution to the explanation of SA, relative to IU. Other significant predictors were average daily smartphone use and entertainment use, the latter being the strongest predictor in the model. These results revealed cyberchondria as a unique predictor of SA.

Predictors of Cyberchondria during the COVID-19 pandemic: A cross-sectional study using supervised machine learning

BACKGROUND

Cyberchondria is characterized by repeated and compulsive online searches for health information, resulting in increased health anxiety and distress. It has been conceptualized as a multi-dimensional construct fueled by both anxiety and compulsivity-related factors and described as a "transdiagnostic compulsive behavioral syndrome" which is associated with health anxiety, problematic internet use and obsessive-compulsive symptoms. Cyberchondria is not included in the ICD-11 or the DSM-5, and its defining features, etiological mechanisms and assessment continue to be debated.

OBJECTIVE

This study aimed to investigate changes in the severity of cyberchondria during the pandemic and identify predictors of cyberchondria at this time.

METHODS

Data collection started on May 4, 2020 and ended on June 10, 2020, which corresponds to the first wave of the COVID-19 pandemic in Europe. At the time the present study took place, French-speaking countries in Europe (France, Switzerland, Belgium and Luxembourg) all implemented lockdown or semi-lockdown measures. The survey consisted of a questionnaire collecting demographic information (sex, age, education level and country of residence) and information on socioeconomic circumstances during the first lockdown (e.g., economic situation, housing and employment status), and was followed by several instruments assessing various psychological and health-related constructs. Inclusion criteria for the study were being at least 18 years of age and having a good understanding of French. Self-report data were collected from 725 participants aged 18 to 77 years (mean 33.29, SD 12.88 years), with females constituting the majority (416/725, 57.4%).

RESULTS

The results show that the COVID-19 pandemic affected various facets of cyberchondria: cyberchondria-related distress and interference with functioning increased (distress z=-3.651, P<.001; compulsion z=-5.697, P<.001), whereas the reassurance facet of cyberchondria decreased (z=-6.680, P<.001). Also, COVID-19-related fears and health anxiety emerged as the strongest predictors of cyberchondria-related distress and interference with functioning during the pandemic.

CONCLUSIONS

These findings provide evidence about the impact of the COVID-19 pandemic on cyberchondria and identify factors that should be considered in efforts to prevent and manage cyberchondria at times of public health crises. Also, they are consistent with the theoretical model of cyberchondria during the COVID-19 pandemic proposed by Starcevic and his colleagues in 2020. In addition, the findings have implications for the conceptualization and future assessment of cyberchondria.

Cyberchondria: a Growing Concern During the COVID-19 Pandemic and a Possible Addictive Disorder?

Purpose of Review

The main purpose of this narrative review is to provide a brief overview of the current empirical evidence regarding the conceptualization, assessment, and treatment of cyberchondria, with a focus on the potential classification of cyberchondria as a behavioral addiction. Although cyberchondria has been widely associated with anxiety, it has also been suggested that it may be linked to obsessive-compulsive features. A less explored proposal is the categorization of cyberchondria as a behavioral addiction. The present review explores the existing literature with respect to the possible classification of cyberchondria as a behavioral addiction by considering cyberchondria with respect to components of the interaction of person, affect, cognition and execution model.

Recent Findings

There is a lack of consensus regarding the definition and conceptualization of cyberchondria. The empirical evidence available to date suggests that cyberchondria is a multifactorial construct that operates transdiagnostically, particularly with respect to obsessive-compulsive-related disorders and health-related anxiety. The extent to which the condition may reflect a behavioral addiction as a form of problematic use of the internet also warrants consideration. Cyberchondria may have become more prevalent during the COVID-19 pandemic, with particular populations prone to health-related anxiety likely having greater vulnerability. Existing data in part support the potential classification of cyberchondria as a behavioral addiction, although many gaps in understanding currently exist.

Summary

Cyberchondria appears to be a growing concern. However, there is not yet enough empirical evidence to determine whether this clinical condition has enough similarities with behavioral addictions to be considered as one. Likewise, psychometric instruments that exist to date have not been designed from the theoretical framework of behavioral addictions, so most of the factors that they evaluate may be preferentially related to anxiety. Finally, there is still no consensus on whether cyberchondria should be addressed in the context of health anxiety interventions, OCRD, or behavioral addictions; thus, more empirical evidence is needed.

Cyberchondria and COVID-19 anxiety and internet addiction among nursing students

This study was conducted to determine the relationship between cyberchondria and COVID-19 anxiety and internet addiction in nursing students. This cross-sectional study was conducted with 843 students studying in the nursing department of Adnan Menderes University. The mean age of the students was 20.8 ± 1.72 years and 61.2% were female. The Cyberchondria Severity Scale-Short Form, Coronavirus Anxiety Scale, and the Young Internet Addiction Test-Short Form were used to collect data. The study found a positive association between internet addiction, cyberchondria severity, and anxiety about COVID-19. It was found that the anxiety of COVID-19 had a mediating role in the association between internet addiction and cyberchondria severity. It was found that the use of the internet as a source of information on health problems and trusting the health information found had a significant effect on high cyberchondria levels (p < 0.05). Taken together, the findings of previous studies and this study on the role of the association between internet addiction and cyberchondria exacerbating anxiety due to the pandemic provide further evidence for healthcare professionals that greater focus is needed on the problems of the new era related to people-internet interaction. To reduce the negative effects of the current health crisis and future health crises, interventions for nursing students to control their internet use and cyberchondria behaviors should be prioritized.

The association between fear of Covid-19 and smartphone addiction among individuals: the mediating and moderating role of cyberchondria severity

The coronavirus disease-2019 (COVID-19) has quickly spread all over the world and has contributed to psychological consequences including fear of the virus. Depending upon the severity of their problems, individuals often search the internet via their mobile devices to understand whether the symptoms they perceive are symptoms of the disease. This condition has been termed 'cyberchondria'. In this context, the aim of this study is examine the mediating and moderating role of cyberchondria severity in the association between smartphone addiction and the fear of COVID-19. The sample comprised 520 participants (335 females [64.4%], 185 males [35.6%] aged 17 to 65 years [Mean = 28.61 years, SD = 10.60]). A survey included the Cyberchondria Severity Scale Short-Form, The Smartphone Addiction Scale-Short Version, and The Fear of COVID-19 Scale. Structural equation modeling and SPSS Process Macro moderator variable analysis were used to test the research model. The study found a positive association between smartphone addiction, fear of COVID-19, and cyberchondria severity. Cyberchondria severity had both moderating and mediating role in the association between smartphone addiction and the fear of COVID-19. In conclusion, it has been determined that during the COVID-19 pandemic, cyberchondria severity has negative effects on individuals' fear of COVID-19.

Testing the spectrum hypothesis of problematic online behaviors: A network analysis approach

The validity of the constructs of problematic Internet or smartphone use and Internet or smartphone addiction has been extensively debated. The spectrum hypothesis posits that problematic online behaviors (POBs) may be conceptualized within a spectrum of related yet distinct entities. To date, the hypothesis has received preliminary support, and further robust empirical studies are still needed. The present study tested the spectrum hypothesis of POBs in an Australian community sample (n = 1,617) using a network analysis approach. Psychometrically validated self-report instruments were used to assess six types of POBs: problematic online gaming, cyberchondria, problematic cybersex, problematic online shopping, problematic use of social networking sites, and problematic online gambling. A tetrachoric correlation matrix was computed to explore relationships between online activities and a network analysis was used to analyze relationships between POBs. Correlations between online activities were positive and significant, but of small magnitude (0.051 ≤ r ≤ 0.236). The community detection analysis identified six distinct communities, corresponding to each POB, with strong relationships between items within each POB and weaker relationships between POBs. These findings provide further empirical support for the spectrum hypothesis, suggesting that POBs occur as distinct entities and with little overlap.

Cyberchondria, Anxiety Sensitivity, Hypochondria, and Internet Addiction: Implications for Mental Health Professionals

Repetitive online searches for health information increase anxieties and result in Internet addiction. Internet addiction, cyberchondria, anxiety sensitivity, and hypochondria have been studied separately, but how these concepts are reciprocally linked has not been investigated. This study aimed to determine the levels, correlations, and predictors of Internet addiction, cyberchondria, anxiety sensitivity, and hypochondria among students based on the sample's characteristics. A sample of 143 university students participated in this cross-sectional online survey. A self-reported questionnaire was employed to collect data from students. The studied concepts had moderate to high correlations with each other and with the students' characteristics. Not getting infected with the coronavirus was among the demographic factors inserted into the regression model that only predicted cyberchondria. The model of cyberchondria was significant and explained 11.5% of the variance in the score of concepts. The results of the standard regression analysis indicated that the model predicting Internet addiction accounted for 41.2% of the variability. Our unique findings indicate that cyberchondria can contribute to developing Internet addiction compared to earlier studies. The findings suggest the importance of empowering students to overcome their anxieties by managing cyberchondria and Internet addiction. Mental health professionals, namely psychiatric nurses, are at the forefront of taking preventive mental health measures on campus, such as screening and referring students who exhibit these problems to psychological support and counseling to cope with their anxieties.

Risiken und Chancen der Digitalisierung

Zusammenfassung. Durch die Digitalisierung ist innerhalb von kurzer Zeit eine zusätzliche Lebenswelt für Kinder und Jugendliche entstanden. Aus kinderpsychologischer Sicht stellt sich deshalb die Fragen, welche Risiken und Chancen die Digitalisierung sowohl für die Kindesentwicklung als auch für die psychotherapeutische Versorgung birgt. Risiken der Digitalisierung, sogenannte online harms („Online-Schäden“), zeigen sich durch Aggravation oder Veränderung bereits bekannter Störungsbilder (z. B. Essstörungen, selbstverletzendes oder suizidales Verhalten, Hypochondrie) oder die Entstehung neuer Störungsbilder (z. B. Online-Verhaltenssüchte wie die Computerspielstörung). Ausschlaggebend erscheint dabei nicht die Zeit, die mit digitalen Medien verbracht wird, sondern das Nutzungsmuster und die Funktionalität der Nutzung. Gleichzeitig bieten digitale Diagnostik, Monitoring- und Feedbacksysteme sowie digitale Interventionen neue Chancen zur Verbesserung der psychotheapeutischen Versorgung. Beispielsweise können Jugendliche durch App-basierte Interventionen im Alltag besser erreicht werden, und auch für unterversorgte Populationen wie beispielsweise Angehörige bieten digitale Angebote einen niederschwelligen Zugang. Die Digitalisierung stellt somit Wissenschaft und Psychotherapie vor große Herausforderungen und neue Aufgaben.

Evaluation of the Psychometric Properties of the Arab Compulsive Internet Use Scale (CIUS) by Item Response Theory Modeling (IRT)

INTRODUCTION

The psychometric properties of the Arab translation of the Compulsive Internet Use Scale (CIUS) have been previously studied by confirmatory factor analysis (CFA) with AMOS software using the asymptotically distribution-free (ADF) estimator. Unidimensionality has been achieved at the cost of correlating several item variance errors. However, several reviews of SEM software packages and estimation methods indicate that the option of robust standard errors is not present in the AMOS package and that ADF estimation may yield biased parameter estimates. We therefore explored a second analysis through item response theory (IRT) using the parametric graded response model (GRM) and the marginal maximum likelihood (MML) estimation method embedded in the LTM package of R software. Differential item functioning (DIF) or item bias across subpopulations was also explored within IRT framework as different samples were investigated. The objective of the current study is to (1) analyze the Arab CIUS scale with IRT, (2) investigate DIF in three samples, and (3) contribute to the ongoing debate on Internet-use-related addictive behaviors using the CIUS items as a proxy.

METHODS

We assessed three samples of people, one in Algeria and two in Lebanon, with a total of 1520 participants.

RESULTS

Almost three out of every five items were highly related to the latent construct. However, the unidimensionality hypothesis was not supported. Furthermore, besides being locally dependent, the scale may be weakened by DIF across geographic regions. Some of the CIUS items related to increasing priority, impaired control, continued use despite harm, and functional impairment as well as withdrawal and coping showed good discriminative capabilities. Those items were endorsed more frequently than other CIUS items in people with higher levels of addictive Internet use.

CONCLUSIONS

Contrary to earlier ADF estimation findings, unidimensionality of the CIUS scale was not supported by IRT parametric GRM in a large sample of Arab speaking participants. The results may be helpful for scale revision. By proxy, the study contributes to testing the validity of addiction criteria applied to Internet use related-addictive behaviors.

The effect of cyberchondria on anxiety, depression and quality of life during COVID-19: the mediational role of obsessive-compulsive symptoms and Internet addiction

Since the global pandemic of the coronavirus disease 2019 (COVID-19), online health information-seeking behaviors have notably increased. Cyberchondria can be a vulnerability factor for the worsening of anxiety-depressive symptoms and quality of life. The current study aims to understand the predictive effect of cyberchondria on health anxiety, anxiety, depression and quality of life considering the mediating effect of obsessive-compulsive symptoms and Internet addiction and the moderating effect of COVID anxiety. 572 Italian participants (66% female; Mean age = 34; SD = 15) took part in a cross-sectional online survey involving CSS-12, MOCQ-R, IAT, SHAI, HADS, WHOQoL-BREF and CAS. Mediation and moderation analyses were conducted. Obsessive-compulsive symptoms and Internet addiction were found to partially mediate the cyberchondria-health anxiety and the cyberchondria-anxiety links and to totally mediate the cyberchondria-depression and the cyberchondria-quality of life links. COVID anxiety was found to moderate the relationship between cyberchondria and anxiety. The findings suggest that compulsivity may have a key role in the explanation of the underlying mechanisms of cyberchondria. Healthcare practitioners should provide additional support for individuals with cyberchondria. As such, cyberchondria is a contributing factor to the exacerbation of anxiety-depressive disorders and may impact on the quality of life.

Dark side consequences of cyberchondria: an empirical investigation

Purpose

Cyberchondria refers to the repeated and excessive search for health-related information online, associated with increased health anxiety. This paper utilizes the protection motivation theory to investigate the negative behavioral consequences of cyberchondria that pose health risks to users, such as trust in the physician, propensity to self-medicate, and therapy compliance.

Design/methodology/approach

The data for the study were collected from a sample of 317 participants in India using an online survey and form. The analysis was conducted using structural equation modeling.

Findings

Cyberchondria negatively affects the trust in physician and positively affects the propensity to self-medicate. Trust in physician negatively affects the propensity to self-medicate and positively affects therapy compliance. Furthermore, trust in physician partially mediates the relationship between cyberchondria and the propensity to self-medicate and completely mediates the relationship between cyberchondria and therapy compliance. Cyberchondria has no direct significant effect on therapy compliance.

Research limitations/implications

Researchers need to examine other behavioral or psychological factors affected by the reduced trust in physicians due to cyberchondria.

Practical implications

Physicians and health care providers should refocus on patients with cyberchondria and regain their trust through quality interactions and services. Policymakers may consider regulating online health information publication to set the standards of information quality and source. Websites and platforms publishing health information online should distinctly label verified information.

Originality/value

This study investigates the damaging effects of cyberchondria's behavioral consequences that pose health risks to users.

Does cyberchondria predict Internet addiction among students during the COVID-19 pandemic? A web-based survey study

BACKGROUND

Previous literature has investigated the association of this phenomenon and Internet addiction. Nevertheless, little research has been conducted to elucidate the predictive associations among these concepts among students.

OBJECTIVE

This study reported students' cyberchondria and Internet addiction, and it examined whether cyberchondria predicts Internet addiction.

MATERIAL AND METHODS

During the COVID-19 pandemic, cross-sectional data were collected using a web survey from a convenience snowball sample of 143 students enrolled in e-learning courses at a governmental university.

RESULTS

A moderate level of cyberchondria and a mild level of Internet addiction was evident among students. A moderate level of cyberchondria and a mild level of Internet addiction was evident among students. Moderate to high significant correlations were reported among the studied concepts and with the sample's characteristics. Cyberchondria and unavailability of the Internet at school were predictors of Internet addiction.

IMPLICATIONS

Healthcare providers, including nurses, should provide information that preserves students' mental health during stressful periods such as the COVID-19 pandemic and should offer clear instructions on stress and anxiety management during such times. A longer scale, especially for cyberchondria, is warranted in future research with a random and larger sample.

CONCLUSIONS

Findings suggest that cyberchondria serves as a predictor of Internet addiction, contrary to findings of previous studies. Various psychosocial interventions should always be initiated to help students prevent or address cyberchondria and Internet addiction.

Time Devoted to Individual, Collective, and Two-Person Sports: Its Association with Risk of Exercise Addiction and Alcohol Use Disorder

INTRODUCTION

Although sport activities have beneficial effects on health, excessive practice can lead to exercise addiction (EA), which can be associated with other addictive behaviors. However, results regarding the comorbidities between EA and alcohol use disorder (AUD) remain heterogeneous. This study aims to investigate the relationship between a proxy of AUD and different sport practices, more specifically focusing on EA.

METHODS

One thousand nine hundred eighty-five (N = 1,985) participants were recruited online and selected to represent the French adult population. Participants were asked to answer questions regarding sport activity, with the EA inventory questionnaire investigating EA, and alcohol consumption, with the CAGE questionnaire investigating a proxy of AUD (score ≥2).

RESULTS

AUD was associated with a higher risk of EA and with more time devoted to collective sports (such as football) and two-person sports (such as tennis). The risk of EA was higher for individual sports (such as running), and the risk of AUD seems to increase with the level of physical activity for collective sport but to decrease for individual sports. The type of sports partly but significantly mediated the relationship between AUD and EA.

CONCLUSIONS

Results support the hypothesis that different types of sport have different risks for EA (individual sports being more concerned) and AUD (collective sports being more concerned). Results suggest that the type of sports may be a crucial variable to understand how physical activity can be a risk factor for alcohol disorders. The social dimension of collective sports should be further investigated to facilitate preventive approaches.

Unveiling the relationships between cyberchondria and psychopathological symptoms

Cyberchondria is a clinical entity of excessive and repetitive online health-related searches, associated with health anxiety, obsessive-compulsive symptoms and intolerance of uncertainty. Its relationships with depressive and somatic symptoms have not yet received much attention. The purpose of this study was to examine the individual and comparative effects of several psychopathology constructs on the severity of cyberchondria. Through an online platform, participants (N = 749) completed specific self-report measures assessing the severity of cyberchondria, anxiety, intolerance of uncertainty, depressive, somatic, and obsessive-compulsive symptoms. Standard and hierarchical multiple regression analyses were used to assess how well the independent variables influenced the levels of cyberchondria, before and after controlling for age, education, and sex. When measures of all constructs were included in the analysis, all were significant predictors of cyberchondria levels, except for anxiety. Health anxiety made the strongest contribution. When age, education and sex were controlled for, all measures except for anxiety were also significant predictors of cyberchondria severity. Our study confirms that health anxiety, obsessive-compulsive symptoms and intolerance of uncertainty are all associated with cyberchondria severity, with health anxiety making the strongest unique contribution. Depression and somatic symptoms also predicted cyberchondria severity. These findings have important implications for research and clinical practice.

Compulsive Internet Use Scale: Psychometric Properties and Associations With Sleeping Patterns, Mental Health, and Well-Being in Lithuanian Medical Students During the Coronavirus Disease 2019 Pandemic

Background: The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, however, it has not been elucidated whether this scale is also applicable to medical students and resident doctors. The first aim of this study was to explore the psychometric properties of the Lithuanian version of the CIUS. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic. Methods: A total of 524 medical students and resident doctors (78.60% women, mean age 24 [SD 3] years old) participated in an online survey between December 2020 and February 2021. Participants completed the CIUS, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Assessment-7 (GAD-7), and the WHO-Five Well-Being Index questionnaire (WHO-5). Results: The confirmatory factor analysis (CFA) suggested brief versions (CIUS-5, CIUS-7, and CIUS-9) rather than the original (CIUS-14) version of the CIUS questionnaire as reliable and structurally stable instruments that can be used to measure compulsive Internet use severity in the sample of medical students and resident doctors. The most prevalent online behaviors were social media use (90.1%), online shopping (15.6%), and online gaming/gambling (11.3%). Students with higher CIUS scores reported significantly lower academic achievements during the 6 months (r = 0.12-0.13; p < 0.006), as well as more severe depressive and anxiety symptoms, worsened sleep quality, and lower sense of well-being (r = 0.21-0.41; p's < 0.001). Both, during workdays (d = 0.87) and weekend (d = 0.33), students spent more time online than resident doctors (p's < 0.001). Conclusion: The brief, 5-, 7-, and 9-item versions of the Lithuanian CIUS are reliable and valid self-report screening instruments for evaluating the severity of PIU symptoms among the medical student population. Symptoms of PIU during the COVID-19 period were associated with worsened self-reported mental health and everyday functioning.

Investigation of the effect of cyberchondria behavior on e-health literacy in healthcare workers

This study aims to examine the effects of nurses' and other healthcare workers' perceptions of cyberchondria on e-health literacy. No sample was selected in the research, and a total of 220 people were surveyed. According to the result of the regression analysis, the perception of cyberchondria explains 12.4% of the total variance on e-health literacy. Based on the findings of the research, it can be said that the increase in the perception of the participants about the excessiveness dimension increases the levels of e-health literacy statistically.